The Alma Blog

Musings, updates, and news from a Portland birth center

25% of Childbearing Aged Women Will Choose A Birth Center as Their Place to Give Birth–and other Good News October 29, 2013

Filed under: Uncategorized — almamidwifery @ 8:24 pm
The fact that a quarter of all women will choose to birth at a birth center is not a surprise to the midwives of Alma. We have become steadily busier every year and the phone keeps ringing! Women on the other end of the phone are asking all sorts of questions about our care. “There is a tremendous curiosity about birth centers”. Said Laura Erickson owner of Alma Midwifery. “It is not uncommon for people passing by to want to come in and look at our birth rooms. We have hired more midwives to keep up with the demand. It is within the midwifery philosophy to keep the midwife to client ratio low. We also added another birth room in case four babies want to all jump on the same birthday. We are well stocked and ready to keep up with this incredible surge of births”!
The Journal of Midwifery & Woman’s Health published a study in January highlighting the benefits to women who choose to give birth in midwifery-run birth centers. The findings reinforce the evidence that midwives provided safe and effective care for pregnancy, birth, and the postpartum period. The rising number of surgical births, and the costs related to that also mean that birth centers are cost effective for insurance companies.
This is just win/win for families that choose birth centers. Since the theme of this blog is “Good News for Birthing Families” I must go on…recently the Affordable Care Act has mandated that Medicaid Reimburse licensed birth center for facility fees. There is still a lot to work out and Medicaid is still trying to find a way for this NOT to happen in Oregon. We may need to call upon consumers to become politically active on this front. Stay tuned! At this point they are not allowing birth centers to receive payment for our facility fees.
As midwives we work hard to advocate for your right to birth where you choose for all these reasons and so many more, but it is much more powerful for consumers to advocate for their rights! Let us know if you have time and energy to devote to this, and we may call on you later!

Royal baby watch! July 22, 2013

Filed under: Uncategorized — almamidwifery @ 2:05 pm

The British royal family is welcoming a baby. You would have been
hiding under a rock to have missed all the speculation about Kate and
William’s upcoming birth.

Now that the baby has arrived, the medical staff has signed a document
declaring the arrival. It was whisked by car to Buckingham Palace
by police escort. Once the announcement is at the palace it will be
placed in a gilt frame and will be displayed on an easel for all to

At Alma we are welcoming the Princes and Princesses of Portland nearly
everyday. With their parent’s permission, (and without police escort)
we write their names and weight on our blackboard. It is displayed in
our flowering courtyard for all to see.

How did you announce your baby? Please post your own announcements here.


Chalkboard art by Jenny Nielson Illustrator and
lettering by various Alma staff


Milk Sharing: A New (Old) Idea March 18, 2013

Filed under: Uncategorized — almamidwifery @ 5:25 pm

There has been lots of press lately about the idea of milk sharing, or milk donation: mothers sharing their breast milk with babies who need it. Some people find it disgusting and dangerous, others think it is totally normal and the best thing for a baby who doesn’t have their own mother’s breast milk.


Why would someone need donated breast milk?

Lots of reasons. Some women cannot produce milk on their own. They may be able to make some amount of milk, but not enough to feed their babies. While this can be rare, it is more common than people realize. Other women are able to produce milk initially but lose their supply due to job restrictions, illnesses, or medications. Adopted babies are also beneficiaries of donated milk, as are preemies: it is quite common for the mother of a premature baby to not have enough milk.

How common is milk sharing?

Milk sharing has along history that predates breast pumps and baby formula. Before baby formula (and its precursor, powdered milk) was available, babies who didn’t have enough milk often didn’t make it. In the best case scenario, a family member or other woman would be asked to wet-nurse the baby. Babies who were not related but nursed by the same woman were known as milk siblings, and shared milk kinship. In contemporary Western culture, people may be squeamish about sharing milk, both because of the sexualization of breasts and of the concern of disease transmission through breast milk.

How can I safely share milk?

There should be a high level of openness between the donor and recipient when sharing milk. Most diseases are not transmittable through breast milk, but viruses like HIV are. If you are a milk recipient, ask your donor questions about their HIV status. If you are a donor be open about your medical history, medications you take, and your diet. Some babies are sensitive to dairy or gluten and can only accept milk from a donor who avoids those things as well. Open communication between both parties is very important.

Warning: the FDA and La Leche League warn against milk-sharing, because they feel that no amount of screening can make it safe. As in all things, we believe in informed choice: learn all you can, know the risks and benefits, then choose what’s right for your family.

What about milk banks?

Milk banks are valuable resources that collect, pasteurize, and distribute human milk. The law does not allow donors to be paid for their milk, but the costly process necessitates that recipients pay around $3-$5 per ounce. For a baby who eats the average of 25 ounces a day, that can be up to $875 a week. Human milk from milk banks is often available in the hospital, but may be reserved for premature or sick babies, and insurance will ususally only cover the costs in cases they deem “medically necessary”.

How do I find donors or recipients?

There are two active groups on Facebook connecting donors and recipients: Human Milk 4 Human Babies and Eats on Feets. They both offer a place to post if you have a need or an offer of milk. At this time, Alma is not posting offers or needs because these forums are so active and useful. There are lots of Alma mamas who need milk, and lots of those with extra as well!


Hopefully, this gave you an overview of milk sharing, and some information to spark your curiosity and make you want to learn more about it and figure out if it’s right for you!

Hopefully this gave you an overview


New Midwifery Bill in Upcoming Legislative Session February 1, 2013

Filed under: Uncategorized — almamidwifery @ 1:40 pm

You may or may not know that being licensed as a midwife in Oregon is optional. Holding a license in the state allows you to carry “Legend Drugs and Devices” (oxygen, medications, suturing material, etc.) and bill Oregon Health Plan. It also requires you to adhere to a set of “risk criteria”, which are guidelines for the midwives’ scope of practice and requirements regarding when to consult or transfer care. All of the Alma primary (Direct-Entry CPM) midwives are licensed by the state of Oregon and, if you were/are an Alma client, you may recall signing a document with those guidelines on it. This legislative session there is a proposed bill to make midwifery licensure mandatory, with an exemption for traditional birth attendants. Here is a letter advising you on how to stay informed about the legislative session and suggesting appropriate venues for expressing your opinion on issues surrounding licensure.


Dear Families, Supporters, and Birth Workers,

The 2013 legislative session (which starts February 1st) may bring significant changes in midwifery regulation in Oregon. Our legislators will be considering a bill which includes mandatory licensure of Direct Entry Midwives, an exemption for traditional midwives, and restored autonomy for the Board of Direct-Entry Midwifery. Regardless of where you stand on these issues, we want to let all homebirth and birth center families and supporters know how to stay informed and give input to your legislators throughout the session.
We are seeking contact information for those of you who would like to get direct e-mails with updates about hearings, meetings, and letter writing campaigns. If you would like to receive these e-mail updates, please email Jocelyn Brown at

If you are on social media, you can consider “liking” Oregon Midwifery Council or Birth Freedom for Oregon on Facebook. Both of these pages will be providing current updates on what is happening, and how can have your voice be heard.

Alternately, you can subscribe to the Oregon Midwifery Council blog on our website ( which will have current updates throughout the session.

Lastly, if you are interested in meeting with legislators in person about this bill and about access to midwifery care in general, please save the date for our Annual Lobby Day, Thursday, February 28th. More information about the lobby day will be available soon.

If you already have input that you’d like to give your representatives about this bill you can look them up at: Please remember, when contacting your legislators, that they are working hard in service of their constituents and want to be approached with kindness and simple information that can best help them represent you. Many of them are unfamiliar with out-of-hospital birth and midwifery and will need basic information to be better able to understand your point of view.

We are looking forward to this active legislative session and believe that Oregon legislators will be best able to carefully consider these important issues if home birth and birth center families put themselves at the center of this process.

Thank you!

Silke Akerson
Oregon Midwifery Council


Also, here is a link to an article summarizing these issues as well as the current struggle to ensure midwives are covered under Oregon Health Plan’s new Coordinated Care Organizations (CCOs).

For those who would really like to get down to the nitty gritty details, here is draft of the proposed bill.


Announcing the Jennifer Warnock Scholarship for International Midwifery Service September 6, 2012

Filed under: Uncategorized — almamidwifery @ 6:50 pm

Alma Midwifery is pleased to announce a scholarship fund in memory of our dear friend and former Alma apprentice, Jennifer Warnock. Jen was a much-loved midwife and dancer, and the kind of person you just wanted to be around. Tragically, we lost her far too soon at the age of 43. In the two and a half years since she died, we have been thinking of the best way to honor her memory and keep her alive in our hearts and minds. The Jennifer Warnock Scholarship for International Midwifery Service is based on our hope to support new midwives who want to do service internationally. We want this to honor Jen’s endless curiosity and her commitment to public service and education. 


The scholarship will be awarded yearly to a new midwife who plans to travel internationally to practice midwifery, and is $1000 gift. 

This year’s recipient is Yvette Blanchette, a midwife who was also an apprentice at Alma at the time Jen worked with us. This month she will travel to Haiti to practice midwifery. Here, in her own words, is Yvette’s story of midwifery in Haiti:

Like many of you, I was listening to the radio on the morning of Jan. 12, 2010 when the news of the devastating 7.0 earthquake in Haiti was announced. As a midwife, I also heard among the statistics of devastation that an estimated 39,000 pregnant women were believed to be affected and now homeless. I immediately thought that while I may not have financial resources to make a real impact, I certainly have a skillset that could serve to support individual women in need of maternity care. So, I joined efforts with a group of like-minded midwives at Mother Health International, to provide midwifery services in the city of Jacmel–located due south of Port Au Prince in one of the hardest hit, under served regions of the country. That first year I spent 9 weeks volunteering at a newly established birth center in a dome tent. We served a large client base providing focused prenatal clinics, childbirth education, labor & birth support, and newborn care with an emphasis on breatfeeding as the nutritional standard for infants. It was something of a midwifery marathon; I personally attended 68 births during my 63 days in country. I returned to Haiti again for 8 weeks in the fall of 2011 as the primary staff midwife at MHI. In addition to motherbaby care, I served as a preceptor for a group of remarkable Haitian women in midwifery training. As of this writing, I am thrilled to report that the first graduate, Ninotte Lubin, one of the students I began apprenticing in 2010, has met requirements to sit for the NARM exam this Fall to qualify for her CPM (certified profession midwife) credential. The preparation of national midwives represents an essential investment towards increasing healthcare accessibility in a country that suffers from a critical lack of basic healthcare infrastructure.
Health Statistics in Haiti:
Haiti is known as the poorest country in the western hemisphere; and this poverty comes with a high price in maternal and neonatal mortality rates. In Haiti only 26% of women have access to maternity healthcare; 3 out of 4 women give birth at home unattended (WHO). Tragically 670 women die per 100,000 live births in Haiti; compared to 24:100,000 in the US (UNFPA). Furthermore, the health of babies is inextricably linked to that of their mothers. In Haiti the neonatal mortality rate is 64:1000 live births (UNFPA). The saddest part of the equation is that a vast majority of maternal and neonatal deaths are from treatable causes such as hemorrhage or infection due to unsanitary conditions; and most [WHO estimates 80%] could be prevented with access to a trained healthcare provider such as a skilled birth attendant.
 I am currently preparing to return to Haiti in September (2012) for my third volunteer assignment, nearly 3 years after the earthquake. My previous experiences in country have proven how humanitarian work connects what is truly meaningful in my own life–a passion for midwifery, right livelihood, cultural immersion, and a desire to contribute to the quality of women’s healthcare in under-served parts of the world. I look forward to this next opportunity to serve birthing families, and also to work along side Ninotte, at a community built birth center supported by Olive Tree Projects
You can help support birthing women in Haiti, with an in-kind gift or financial contribution towards the purchase of any of the items listed below, which I hope to carry with me to the  birth clinic in September. Wish List:
  • Clean birth kits–$10.ea
  • Sterile suture kits–$12. ea
  • Alternative remedies: false unicorn root, cotton root bark, crampbark tinctures; homeopathic cimicifuga rac., caulophyllum, arnica; EPO, yunnan baiyao–$5-15. ea
  • Sponsor a Haitian midwife, provide a carry kit with basic midwifery equipment and a copy of the Hesperian Foundation’s Book for Midwives translated in Creole–$99.ea
  • Kindle Fire tablet for clinical documentation, medical reference, and teaching resources–$199.
  • Birth model set for childbirth education–$240
  • Doppler, fetal monitor–$575.
  • Finally, AA (American Airline) miles you might care to share towards this midwife’s roundtrip airfare to Port-Au-Prince. It’s really easy to transfer miles by logging into the website, clicking on AAadvantage, then “buy & share miles”, (contact me for my AA account info).
Thank you for supporting the midwifery model of care everywhere; and specifically our efforts to reduce maternal & neonatal mortality rates in Haiti.   
We are glad to support Yvette in this endeavor, and look forward to hearing about her work when she returns!   



Midwife as hip status symbol? June 19, 2012

Filed under: Uncategorized — almamidwifery @ 12:16 pm

Is having your baby with a midwife the cool thing to do?

“Are midwives becoming trendy, like juice cleanses and Tom’s shoes? It seems that way, at least among certain well-dressed pockets of New York society, where midwifery is no longer seen as a weird, fringe practice favored by crunchy types, but as an enlightened, more natural choice for the famous and fashionable. “The perception of midwives has completely shifted,” said Dr. Jacques Moritz, director of the gynecology division at St. Luke’s-Roosevelt and a consulting obstetrician for three midwife practices. “It used to be just the hippies who wanted to go to midwives. Now it’s the women in the red-bottom shoes.””

Read the rest.



How long should I nurse my baby? June 13, 2012

Filed under: Uncategorized — almamidwifery @ 2:17 pm

Most people agree that if you can nurse your baby, breast milk is the best baby food available (although even that is a controversial idea in some circles!). For many families, the question is not should I nurse, but for how long? Breastfeeding beyond the first year, known as extended breast-feeding is something women in many other countries take for granted. In the US, however, it can be a very controversial topic. Take the recent uproar over the Time Magazine article about Attachment Parenting, an aspect of which is extended breastfeeding. The cover photo of the article that has generated so many comments:

This photo, and the article associated with it, entitled “Are you mom enough” has sparked lots of conversation about parenting, motherhood, and what is best for babies and children. Matt Bors, a political cartoonist (and partner to one of our lovely Junior Midwives), made this comic in response:

Would a magazine cover showing a three-year-old drinking soda or eating fast food have generated the same response? What do you think? How long did you nurse your babies, and why did you choose that length of time?